Prime Minister Keir Starmer pledged a reform of the dental contract when coming to power but with bruising local election results, Labour leadership rivals circling and the Reform Party crowing, will he be able to deliver?
‘Unless we get that consultation and make progress on this, their ambition to reform the contract during this parliamentary term is going to be under pressure,’ British Dental Association (BDA) chair Eddie Crouch told Dentistry.co.uk at the Dentistry Show in Birmingham last week.
Wes Streeting quit his position as health secretary to stand against Starmer, with James Murray, the Labour MP for Ealing North, taking on the role with the largest public service departmental budget.
‘I don’t know whether that will be a good thing or a bad thing, because it’s the Treasury that’s holding up the real progress here,’ Crouch responded when asked if the change would impact discussions.
‘I think change obviously is uncertain. We know that the government at the moment are having their political problems. What I hope is that a minister that I’ve built up a relationship with over the last two years, who I believe has got the right motives, will continue in post, irrespective of who eventually ends up leading the Labour Party,’ he added.
‘Deliver the change I promised’
A public consultation on contract reform had been expected in spring but has now slipped to summer. Crouch noted that Westminster does tend to have longer summers than most.
That summer will be dominated by a leadership challenge following the 7 May local elections – Labour lost ground as Reform won 1,454 council seats, more than any other party.
‘Tough days like this don’t weaken my resolve to deliver the change that I promised,’ Starmer said after the vote, though he acknowledged that voters were clearly unhappy about ‘the pace of change’ that Labour had delivered.
Crouch said there was a direct electoral incentive to act.
‘There’s a huge percentage of Labour MPs who get mailbags full of dental problems, who get told on the doorstep that dentistry is important to them. If they don’t fix NHS dentistry by the end of this term, I think they’ve got no chance at the ballot box. And the investment needed is not an awful lot in the grand scheme of things – dentistry is about 3% of the NHS budget.’
If Labour fails to act, Reform are lying in wait. According to the PollCheck poll tracker, which draws on data from all major UK pollsters, Reform held a 28% share of voting intention as of 18 May, the largest of any party. The next election must be called before August 2029.
Reform Party Dentistry Plan
But what would dentistry look like under a government led by Reform leader Nigel Farage? Dentistry does not feature directly in the Reform Party’s manifesto, and requests for detail from Dentistry.co.uk to the party have gone without reply.
Farage has addressed the access crisis in public statements, acknowledging that ‘people are pulling out their own teeth’ and, responding to the widely reported queues outside a Bristol dental practice in 2024, attributing the pressure on services partly to migration-driven population growth.
Reform’s wider policy platform would have significant implications for the dental workforce. The party has pledged to scrap indefinite leave to remain and replace it with a five-year renewable visa with higher salary thresholds, mandatory English fluency, and stricter character requirements. The current skilled worker visa threshold sits at £41,700 – a level that already effectively excludes most dental nurses. Raising it further could affect dental therapists, hygienists and technicians currently on skilled worker visas.
The party has also pledged to prioritise British workers and ‘end the importation of cheap foreign labour’. This sits in tension with the current composition of the dental workforce: GDC figures published earlier this month showed that more than half (53%) of dentists who joined the register in 2025 were internationally qualified. The Association of Dental Groups (ADG) has previously described allowing more overseas professionals to practise in the UK as the ‘low hanging fruit’ solution to the workforce crisis.
On tax, Reform has pledged to cut income tax thresholds, reduce business taxes, and remove inheritance tax from family farms and family-run businesses – measures that could benefit some practice owners.
What has Reform said about the NHS?
Reform has also pledged that the NHS would ‘remain free at the point of use, funded by general taxation’, though the party has not set out any specific commitments on dental access or NHS contract reform.
The policy states:
Protect the NHS
Under a Reform UK government, the NHS will remain free at the point of use, funded by general taxation. We will improve the NHS by working to redirect funding from back office bloat back into frontline services. Successive Conservative and Labour governments have failed our NHS, leaving patient satisfaction and clinical outcomes at record lows.
Whether a Reform government could act on any of this remains an open question. The party fielded 609 candidates at the 2024 general election and is currently recruiting for an approved parliamentary candidates list ahead of 2029 – suggesting it has not yet reached the full coverage needed to mount a realistic challenge for an outright majority without coalition support.
For Crouch, the more important point is that the political will to fix NHS dentistry transcends any single party.
‘I believe that there is a parliamentary will to actually improve dentistry, and that’s across all parties – whether I meet the Greens, the Liberal Democrats, the Conservatives or Labour. Everyone wants NHS dentistry to be resolved. With that political will, we have reason to be optimistic,’ he said.
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